Autoantibodies in Sheehan's Syndrome

Engelberth, O; Jezková, Z

doi:10.1016/s0140-6736(65)91361-9

Cited by 65 publications

(18 citation statements)

References 9 publications

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“…Autoantibodies to adenohypophysial cell antigens were first revealed in women during the postpartum period, and antibodies persisting for 6-12 months after labour were associated with the development of pituitary insufficiency in 25% of cases compared with 4% in women who did not show these antibodies (Engleberth & Jezkova 1965). Antipituitary antibodies were later found in patients with different disorders: Turner's syndrome (Bottazzo et al 1980), primary empty sella syndrome (ESS), various kinds of pituitary deficiency, idiopathic panhypopituitarism, prolactinoma, inactive pituitary tumour (Komatsu et al 1988, Sauter et al 1990), Cushing's disease (Sherbaum et al 1987) and hypogonadism (Barkan et al 1985).…”

Section: Introductionmentioning

confidence: 99%

Antibodies to pituitary surface antigens during various pituitary disease states

Keda¹,

Krjukova²,

Иловайская³

et al. 2002

Journal of Endocrinology

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Autoantibodies to cell surface antigens of human somatotropinoma (ASAS), human prolactinoma (ASAP) and rat adenohypophysis (ASARA) were assayed in the serum of patients with pituitary diseases associated with GH deficiency (GHD), such as pituitary dwarfism and primary empty sella syndrome (ESS), and in the serum of patients with hyperprolactinaemia of different etiologies: idiopathic hyperprolactinaemia, prolactinoma and ESS. The investigation was carried out with a cellular variant of an ELISA. Among children with GHD, the highest percentage of antibody-positive patients was found in the group with idiopathic isolated GHD (89% of ASAS + patients and 30% of ASARA + patients vs 33·3% and 0% respectively in the group with idiopathic combined pituitary hormone deficiency, and 33·3% and 9% in patients with pituitary hypoplasia associated with isolated GHD or combined pituitary hormone deficiency). Among hyperprolactinaemic patients, the highest ASAP and ASARA frequency was observed in patients with idiopathic hyperprolactinaemia (67·7% and 41·9% respectively) where it was twice as high as in the group of patients with prolactinoma.

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Section: Introductionmentioning

confidence: 99%

Antibodies to pituitary surface antigens during various pituitary disease states

Keda¹,

Krjukova²,

Иловайская³

et al. 2002

Journal of Endocrinology

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“…The involvement of the autoimmune process in the pathogenesis has been suspected on the basis of histological and experimental findings [14], by demonstrating circulating anti-pituitary antibodylike substances [7], or the association with other autoimmune endocrine disorders [1,3,6,10] Furthermore, antibodies to the anterior pituitary cells (anti-pituitary antibody) were demonstrated in some cases of Sheehan's syndrome [15] and several types of anterior pituitary hypofunction [16]. However, the pathophysiology of the aforementioned disorder, and the physicochemical properties of anti-pituitary antibody remain unclear.…”

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confidence: 99%

Anti-Pituitary Antibodies in Patients with Hypopituitarism and Their Families: Longitudinal Observation.

et al. 1991

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Abstract. In an attempt to investigate the clinical significance of anti-pituitary antibodies in patients with hypopituitarism, anti-pituitary antibody in plasma was examined in 10 such patients (7 cases of isolated ACTH deficiency, 1 of partial hypopituitarism, and 2 of Sheehan's syndrome), on two or three occasions with an interval of more than 6 months (longitudinal study). In a total of 16 relatives of these 4 patients (2 cases of Sheehan's syndrome, one in each of partial hypopituitarism and isolated ACTH deficiency) and one patient not involved in the longitudinal study, anti-pituitary antibodies were also examined (family study). Anti-pituitary antibodies reacting with rat pituitary cytoplasmic antigens (pituitary cell antibodies: PCA) and pituitary cell surface antibodies (PCSA) reacting with GH3 cells and/or AtT-20 cells were measured with indirect immunofluorescence. The longitudinal study revealed the disappearance of antibodies in 3 patients, 2 PCA positive and one both PCA and PCSA positive. In 3 patients, altered antibody titers or a newly appearing antibody were found during the follow-up period.

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“…Most of the reported cases with postpartum hypopituitarism were diagnosed to have Sheehan's syndrome associated with necrosis of the anterior pituitary gland which probably resulted from ischemia induced by massive postpartum hemorrhage (Sheehan, 1937;Sheehan and Stanfield, 1961;Sheehan, 1961;Goluboff and Ezrin, 1969;Stacpoole et al, 1983). Several cases of hypopituitarism, however, have recently been reported in women who had a normal course of pregnancy and delivery (Richtsmeier et al, 1980;Mayfield et al, 1980;Smallridge et al, 1980;Asa et al, 1981;Baskin et al, 1982;Fleckman et al, 1983;Notterman et al, 1984). It is hard to relate such hypopituitarism to ischemic damage to the anterior pituitary gland.…”

Section: Discussionmentioning

confidence: 99%

“…Several cases of hypopituitarism following a normal course of pregnancy and delivery have been reported (Richtsmeier et al, 1980;Mayfield et al, 1980;Smaliridge et al, 1980;Asa et al, 1981;Baskin et al, 1982;Fleckman et al, 1983;Notterman et al, 1984). In the absence of the massive hemorrhage, the mechanism for such postpartum hypopituitarism remains unclear.…”

mentioning

confidence: 99%

“…In the absence of the massive hemorrhage, the mechanism for such postpartum hypopituitarism remains unclear. Engelberth and Jeikova (1965) reported that anti-pituitary gland antibody was sometimes demonstrated in women soon after delivery, and some such women developed hypopituitarism later. Hypophysitis with lymphocyte infiltration was detected in the pituitary gland in a number of such patients, suggesting the participation of an autoimmune mechanism in the pathogenesis of some cases of post-partum hypopituitarism (Richtsmeier et al, 1980;Mayfield et al, 1980;Asa et al, 1981;Baskin et al, 1982;Notterman et al, 1984).…”

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confidence: 99%

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A case of partial hypopituitarism with empty sella following normal course of pregnancy and delivery.

Okada¹,

Ishikawa²,

Saito³

et al. 1986

Endocrinol Japon

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A 28 year-old woman was admitted to Jichi Medical School Hospital because of amenorrhea, cold intolerance, easy fatigability and body weight loss. She was pregnant at the age of 26 years.She delivered a 3230 g healthy girl at full term without any complications.However, she did not have any lactation or recurrence of menstruation after the delivery. Serum cortisol was 0.7Both hormones failed to increase in response to insulin-induced hypoglycemia or exogenous arginine vasopressin. However, serum cortisol and urinary excretion of 17-hydroxycorticosteroids (17-OHCS) were significantly increased by the repeated administration of ACTH. Serum prolactin was 2.2ng/ml and the level did not rise after the administration of thyrotropin releasing hormone (TRH).Responses of release of adenohypophysial hormones including gonadotropins, growth hormone and thyroid stimulating hormone (TSH) were normal. Serological studies showed an antibody to the pituitary gland which was demonstrated by an indirect immunofluorescence technique. Plain skull X-ray film and brain computerized tomography revealed an empty sella of the normal size. These results indicate the presence of partial deficiency of ACTH and prolactin, and that autoimmune disorders may be involved in the pathogenesis of her hypopituitarism.

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Autoantibodies in Sheehan's Syndrome

Cited by 65 publications

References 9 publications

Antibodies to pituitary surface antigens during various pituitary disease states

Antibodies to pituitary surface antigens during various pituitary disease states

Anti-Pituitary Antibodies in Patients with Hypopituitarism and Their Families: Longitudinal Observation.

A case of partial hypopituitarism with empty sella following normal course of pregnancy and delivery.

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